基于腹膜炎拔管的腹透患者术后手术部位感染的治疗及转归  

Treatment and outcomes of postoperative surgical site infections in peritoneal dialysis patients with catheter removal due to peritonitis

作　　者：齐心[1] 何睿[1] 李会娟[1] 温冰[1] 刘玉村[2] 曲贞[3] 董捷[3] 

机构地区：[1]北京大学第一医院整形烧伤科,北京100034 [2]北京大学第一医院普通外科,北京100034 [3]北京大学第一医院肾内科北京大学肾脏疾病研究所,北京100034

出　　处：《中华医院感染学杂志》2016年第18期4179-4181,共3页Chinese Journal of Nosocomiology

基　　金：国家科技支撑计划基金资助项目(2012EP001002)

摘　　要：目的总结因腹膜炎而拔除腹透管后出现手术部位感染病例的临床和病原学特点及外科治疗经验,结合文献分享治疗体会。方法回顾性分析2008年1月-2015年12月因腹膜炎而拔除腹透管后出现手术部位感染的病例,总结其临床特点、治疗及转归情况;采用SPSS20.0软件进行统计分析。结果共125例拔管患者,其中7例出现手术部位感染,感染率为5.6%;平均发生时间为拔管后第11天,感染均局限于皮下脂肪层,经清创换药治疗,所有患者伤口均愈合,平均愈合时间(41.7±20.3)d;通过平均6.4个月的随访,1例患者因消化道出血、多器官功能衰竭死亡,其余6例患者伤口均无复发。结论拔管术中注意组织保护,术后密切观察伤口,一旦发生感染应及早进行手术干预。OBJECTIVE To explore the clinical and etiological characteristics of surgical site infections in peritoneal dialysis patients with catheter removal due to peritonitis,summarize the experience of surgical treatment,and share the treatment experience combined with the literature review.METHODS From Jan 2008 to Dec 2015,all of the patients who had the surgical site infections after removal of peritoneal dialysis catheter due to peritonitis were retrospectively analyzed,and the clinical characteristics,treatment,and outcomes were observed;the statistical analysis was performed with the use of SPSS20.0software.RESULTS Of totally 125 patients who were with removal of catheter,7had surgical site infections,with the infection rate of 5.6%;the mean time of occurrence was at Day 11 after the catheter removal;the subcutaneous fat layer was the only infection site,the wounds of all the patients were healed after debridement and drug dressings,and the mean healing time was（41.7±20.3）days.The average follow-up of 6.4months showed that 1patient died of gastrointestinal bleeding and multiple organ failure and that the wounds of the rest of 6patients did not relapse.CONCLUSIONIt is necessary to pay attention to the protection of tissues during the removal of catheter,closely observe the wounds after the surgery,and carry out surgical interventions as soon as the infections occur.

关 键 词：腹膜透析 腹膜炎 手术部位感染 

分 类 号：R656.41[医药卫生—外科学]